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Private insurance companies sell Utah Medicare Supplement Plans to fill the coverage gaps in Original Medicare. They will typically cover both your Part A deductible and your 20% Part B coinsurance, among other things. But while they are sold by private companies, the Centers for Medicare and Medicaid Services (CMS) regulates these plans on behalf of the federal government. The CMS mandates that all plans with the same letter name must offer the same benefit coverage throughout the country.
But despite the fact that benefits are standardized, insurance companies are free to determine their own premium rates. That means rates can vary based on the insurer you choose. So, it is essential to investigate and evaluate a variety of available options. You’ll need to compare all of the plans and insurers that are available to you with the help of EZ. But before you do that, take a look at our guide to the Virginia Medicare Supplement Plan rules and regulations.
Virginia Medicare Supplement Plans
A Medicare Supplement Plan is your best choice if you want extra coverage to fill the gaps in Original Medicare. Especially the 20% coinsurance you have to pay every time you use Medicare Part B outpatient services.
In the state of Virginia, there are 10 different standardized Medicare Supplement Plans available. Each one is named with a different letter of the alphabet (A, B, C, D, F, G, K, L, M, and N). It’s important to remember that not every insurance company will offer every plan. But CMS requires that every insurance company offer Plan A to their customers. In addition, people who qualified for Medicare before January 1, 2020 will be the only ones who can buy Plans C and F.
You will have to pay a monthly premium for these plans. But they will cover most or all of your out-of-pocket costs. Medicare Supplement Plans in Virginia have monthly premiums that can start anywhere from $47 to $184, depending on where you live and which plan you choose.
There are so many different things to think about when it comes to Medicare Supplement Plans that it can be hard to keep track of everything. To help you start, we’ve given an overview of what each plan in Virginia covers and how much it costs.
Plan A
Plan A is the most basic Medicare Supplement Plan. But even though it’s basic, it will cover what is probably the most important thing that Medicare Supplement Plans cover: the 20% of outpatient services that Original Medicare doesn’t pay for. It also covers a handful of other basic, but necessary, expenses.
Plan A must be offered by all Medicare insurance companies, but in some areas, insurers are not required to offer it to people under 65 who are getting disability benefits from Medicare.
In Virginia, the monthly price for Plan A starts at $84.
Plan B
Medicare Supplement Plan B covers all the basics that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period, after that you are required to pay a portion of your bills for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day. If your stay is between 91 and 150 days, and you use your Lifetime Reserve days, your coinsurance will be $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
What makes Plan B less basic than Plan A is that it covers Medicare Part A deductibles, which Plan A does not. The Part A deductible is $1,600 (as of 2023) per benefit period. And because the deductible is based on 60-day benefit periods instead of annual benefit periods, you may have to pay your Part A deductible more than once in a single calendar year. So, if you want hospital stays more fully covered than they are with Original Medicare, Plan B might be a better choice than Plan A.
In Virginia, the premiums for Plan B start at $104 per month.
Plan C
Medicare Supplement Plan C is one of the most comprehensive Medicare Supplement Plans, but not all Medicare recipients can get it. Plan C will pay for all of your out-of-pocket costs, except for Medicare Part B excess charges, which are not covered. This means that Plan C will pay for your Parts A and B deductibles as well as the 20% coinsurance you would normally have to pay for all outpatient services.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Plan C is not available to Medicare recipients who joined the program after January 1, 2020. If you had Plan C before that date, you can keep it. If you were eligible for Medicare before January 1, 2020 but didn’t sign up, you may still be able to buy Plan C.
Medicare Supplement Plan C monthly premiums in the state of Virginia start at $124.
Plan D
Plan D covers the majority of the out-of-pocket expenses associated with Original Medicare, including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
Medicare Supplement Plan D does not cover the Medicare Part B deductible or Part B excess charges. If your doctor refuses to accept Medicare assignment, they can charge you more than Medicare would pay for the service, and you will have to pay the difference. The difference between your doctor’s bill and the amount that Medicare will pay is called an “excess charge.” With Plan D, you will have to pay for this difference, so if you think you will want to see providers who do not accept Medicare assignment, you should look into a different plan.
In Virginia, the monthly premiums for Plan D start at around $184.
Plan F
Medicare Supplement Plan F has long been the best-selling plan on the market, but it is not currently available to all beneficiaries. It covers all of your out-of-pocket expenses, meaning you’ll only pay your monthly Plan F premium if you have this plan. The covered expenses include:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
Anyone who became or becomes Medicare-eligible after 2020 will not be able to enroll in Plan F. You can enroll in one of these plans if you first became eligible for Medicare before 2020, and you can keep your Plan F indefinitely if you have already purchased it.
Plan F premiums start at around $116 a month in Virginia.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of these plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
Plan G covers everything except the Part B deductible, and the premiums for Plan G are usually less than those for Plan F. Medicare Supplement Plan G premiums in Virginia, for example, start at just $92 per month.
Plan K
Medicare Supplement Plan K helps pay for some of the costs not covered by Original Medicare. To keep your out-of-pocket costs down, Plan K covers 50% of some expenses. This plan covers half of the following:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% Part B coinsurance. For example, if your doctor charges $100 for a service, Medicare will cover $80, Plan K will cover $10, and you will cover the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800. Plan K requires you to pay the Medicare Part B deductible, which is $226 in 2023.
Plan K has higher costs at the point of service than other plans, but it also has an annual out-of-pocket maximum, which other plans and Original Medicare don’t have. This means that if you have Plan K, your out-of-pocket expenses won’t go over $6,620 per year (as of 2023). Once you reach that amount, Medicare Supplement Plan K will cover all of your approved costs. Your limit will be reset at the beginning of each new year.
In addition, while Plan K only covers half of some of your costs, it covers all of your Medicare Part A coinsurance. If you stay in the hospital for more than 60 days, Medicare Part A requires you to pay coinsurance. So, this is an excellent benefit to have if you end up requiring hospitalization.
Plan K has higher out-of-pocket costs than other plans, but the premiums are lower, starting at just $47 per month in Virginia.
Plan L
The bulk, but not all, of the costs associated with Original Medicare are covered by Medicare Supplement Plan L. But it covers them at a higher percentage than Plan K does. And, like Plan K, Plan L has an annual out-of-pocket maximum ($3,310 in 2023, which is lower than Plan K’s), after which your insurance carrier will pay 100% of your medical costs.
Your Medicare Part A copayments and hospitalization charges will all be covered in full by Medicare Supplement Plan L. It also provides partial coverage for:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period. You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Plan L premiums start at $80 a month in Virginia.
Plan M
Medicare Supplement Plan M helps with some, but not all of the costs, that come with Original Medicare. But, unlike those plans, it covers many of your out-of-pocket expenses in full.
Medicare Supplement Plan M includes coverage for all Medicare Part A hospitalization costs and Part A copayments. It also covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A deductible – Medicare Supplement Plan M will cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
Plan M premiums start at $161 a month in Virginia.
Plan N
Medicare Plan N is a very comprehensive Medicare Supplement Plan. It covers almost everything with the exception of the Part B deductible ($226 in 2023) and any Part B excess charges. Plan N, though, does require copayments for specific services, in contrast to some other plans.
Those who enroll in Medicare Supplement Plan N will have coverage for the following:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
Plan N premiums start at $69 a month in Virginia.
When To Enroll
While you can technically enroll in a Medicare Supplement Plan at any time. There is one time when enrolling will be most advantageous for you. When you turn 65 and enroll in Medicare Part B, you are eligible for your Medicare Supplement Open Enrollment Period. Which lasts for a full six months.
If you apply for a plan during this six-month window, you will be granted “guaranteed-issue rights,”. Meaning insurers cannot deny you or charge you more for coverage. You will only be granted this Open Enrollment Period once. So, it’s in your best interest to take advantage of it.
And if you are a Medicare beneficiary who is under 65. You should know that the majority of insurers in Virginia offer Plan A. But with that being said, the premiums for these enrollees are significantly higher than the premiums for individuals who are eligible for Medicare due to age.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and help you with signing up. EZ can assist you in enrolling in Medicare, comparing Virginia Medicare Supplement Plans, or simply weighing your options. Our agents work with the best insurance companies in the country. So, they can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
